| NPI | 1588996748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3126) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH23798) |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2010-02-12 |